Editor’s Note: This piece is part of MOAA’s 2020-21 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Mercer Consumer. A version of the guide appeared in the November 2020 issue of Military Officer magazine.
By MOAA Staff
Welcome to another installment of “You Ask, MOAA Answers” where we discuss some of the most commonly asked member questions. This video is brought to you by MOAA Insurance Plans, administered by Mercer Consumer. Make the most out of your MOAA member benefits and prepare for the future by going to MOAA.org/insurance.
Today’s installment: Making sense of your family’s TRICARE coverage when you turn 65. Let’s get started.
[TRICARE GUIDE: Medicare and TRICARE at 65 and Beyond]
Q. How does TRICARE fit with Medicare?
A. At age 65, TRICARE health care plans morph into the TRICARE For Life Medicare supplement plan, also known as TFL. For TFL to function, you must have Medicare Parts A and B. Health care providers bill Medicare as the primary payer and TRICARE as the secondary payer.
Q. What are the steps to make a timely and smooth transition to Medicare?
A. Regardless of your age or the age of your spouse, you will not lose medical coverage. Simply enroll in Medicare and TRICARE For Life.
Your window to apply starts three months before the month you turn 65. It lasts seven months.
But don’t wait. Two or three months before your birthday, visit Medicare.gov and enroll. Early enrollment ensures you receive your Medicare card in the mail. Your TFL coverage begins the first day you have both Medicare Parts A and B; there is no separate enrollment paperwork for TRICARE For Life.
Q. What do I pay for Medicare?
A. Medicare Part A has no premium. Part B has a monthly premium based on your income level.
The Part B premium is per person, per month. Medicare uses the last reported tax filing, two years ago, from the IRS to determine your income level. Search “Part B Cost” at Medicare.gov to find your current cost.
Q. How does Medicare work?
A. Medicare works like TRICARE Select or other Preferred Provider Organizations, or PPOs. That means no primary care manager, no referrals for specialists, no being told where to go. You can choose any providers, specialists included, if they accept Medicare.
Find out whether your current medical providers accept Medicare. If they do, there’s no need to change providers. If not, you’ll need to shop for new ones.
Q. What if I’m working and covered by my employer health plan at age 65?
A. If you continue to work past age 65 AND you are covered by your employer’s health care plan, you can delay Medicare enrollment until your employment ends or your employer’s health plan stops, whichever comes first. This is the only scenario that allows for delayed Medicare enrollment without the Medicare late enrollment premium penalty. You’ll have eight months to enroll in Medicare after you retire or your coverage under an employer plan ends.
Plan carefully to start Medicare to prevent a gap before your employer plan ends. Medicare cannot be delayed by using a civilian retiree health plan. And TRICARE Prime and Select end at age 65.
Q. What if I travel overseas?
A. Medicare plans do not work overseas. If you travel, your TFL converts to TRICARE Select Overseas. You’ll be covered at TRICARE Select rates. You will pay for services overseas out of your own pocket and be reimbursed by TRICARE after you file a claim.
Q. What if I have additional questions?
A. Understanding all the nuances of health care can be tricky. MOAA has subject-matter experts on hand to assist Premium and Life Members. Call (800) 234-6622 or email firstname.lastname@example.org and we can properly direct you to assistance.
If you have coverage-related questions, or questions about medical services, it is best to contact your health care service provider directly.